BACKGROUND.Trauma ranks as one of the leading cause of mortality in Sub-Saharan Africa. The aim of this study was to compare the pattern of injuries and mortality rates in our hospital.METHODS.Demographic and clinical data of patients that sustained injuries due to trauma to all regions of the body were included in the study. The cause; type and site of the injuries were documented. Cases of mortality with the sites and severity of injuries and number of days on admission before death was documented for each period.RESULTS.A total of 673 patients presented in the first period (March 2011 to February 2012) and 1869 in the second period (March 2012 to February 2013). More males were involved with injuries in both periods. RTA and Burns were responsible for most of the injuries in both periods. Head injury was highest followed by the extremities in both periods. In the first period; a total of 46 patients died with mortality rate of 6.8%; in the second period; a total of 47 patients died with mortality rate of 2.5%.CONCLUSION.There was an increase in the cases of trauma in the second period of the study. The pattern in both periods was similar but mortality figure was much lower in the second period.

BACKGROUND.Trauma ranks as one of the leading cause of mortality in Sub-Saharan Africa. The aim of this study was to compare the pattern of injuries and mortality rates in our hospital.METHODS.Demographic and clinical data of patients that sustained injuries due to trauma to all regions of the body were included in the study. The cause; type and site of the injuries were documented. Cases of mortality with the sites and severity of injuries and number of days on admission before death was documented for each period.RESULTS.A total of 673 patients presented in the first period (March 2011 to February 2012) and 1869 in the second period (March 2012 to February 2013). More males were involved with injuries in both periods. RTA and Burns were responsible for most of the injuries in both periods. Head injury was highest followed by the extremities in both periods. In the first period; a total of 46 patients died with mortality rate of 6.8%; in the second period; a total of 47 patients died with mortality rate of 2.5%.CONCLUSION.There was an increase in the cases of trauma in the second period of the study. The pattern in both periods was similar but mortality figure was much lower in the second period.

Background: Bruises commonly occur in children and are often due to minor accidental injuries. However, they can also occur in bleeding disorders or inflicted injuries (physical abuse) and is often the most common visible manifestation of child physical abuse.Objective: This paper aims at highlighting the factors that should raise concern about nonaccidental injury (physical abuse) in children presenting with bruising and the approach to their evaluation. Method: This paper is based ona manual literature search and review of relevant papers sourced from Pubmed using the search terms “bruising, non-accidental injuries in children, evaluation.Conclusion: It is instructive to carefully and thoroughly evaluate bruise in children utilizing peer review and the necessary ancillary tests. It is also advisable to always consider other possible causes of bruise and bruise-like lesions in forming opinion about suspected bruise as implications of false diagnosis are grave.

Background: Bruises commonly occur in children and are often due to minor accidental injuries. However, they can also occur in bleeding disorders or inflicted injuries (physical abuse) and is often the most common visible manifestation of child physical abuse.Objective: This paper aims at highlighting the factors that should raise concern about nonaccidental injury (physical abuse) in children presenting with bruising and the approach to their evaluation. Method: This paper is based ona manual literature search and review of relevant papers sourced from Pubmed using the search terms “bruising, non-accidental injuries in children, evaluation.Conclusion: It is instructive to carefully and thoroughly evaluate bruise in children utilizing peer review and the necessary ancillary tests. It is also advisable to always consider other possible causes of bruise and bruise-like lesions in forming opinion about suspected bruise as implications of false diagnosis are grave.

BACKGROUND: Genitourinary injuries (GUI) are relatively uncommon. Even though mortality from isolated injuries is rare; they are commonly associated with significant and life long morbidity. OBJECTIVE: This study is to assess the pattern of the injuries and the overall short term treatment outcome in our environment. METHODS: Fifty consecutive patients diagnosed with genitourinary injuries seen by the Urology Unit through the Accident and Emergency; emergency referrals (or consultations) from the ward or theatre between June 2004 to February 2006 were included in the study. Information collected included demographic data; pattern of presentation; aetiology of injury; type of injury the type of treatment and the immediate outcome. RESULTS: There was a total of 61 injuries in 50 patients. Road traffic accidents was the commonest cause of GUI (58) followed by straddle injuries (18) and iatrogenic causes (12) and miscellaneous (12). The male- female ratio was 6:1. The urethral was also the most commonly injured organ (60.6); followed by the kidney (11.5). The testes were the least injured organs (1.6). The blunt renal injuries and extraperitoneal bladder injuries were managed by non operative means while most other injuries were managed by surgical intervention. Immediate treatment outcome was satisfactory in most patients. There was one mortality. CONCLUSION: Most cases of GUI are preventable. Improved safety on the roads;'proper training of surgeons and attention to clinical and surgical details will go a long way in preventing GUI. Early intervention significantly reduces the morbidity and mortality.

BACKGROUND: Genitourinary injuries (GUI) are relatively uncommon. Even though mortality from isolated injuries is rare; they are commonly associated with significant and life long morbidity. OBJECTIVE: This study is to assess the pattern of the injuries and the overall short term treatment outcome in our environment. METHODS: Fifty consecutive patients diagnosed with genitourinary injuries seen by the Urology Unit through the Accident and Emergency; emergency referrals (or consultations) from the ward or theatre between June 2004 to February 2006 were included in the study. Information collected included demographic data; pattern of presentation; aetiology of injury; type of injury the type of treatment and the immediate outcome. RESULTS: There was a total of 61 injuries in 50 patients. Road traffic accidents was the commonest cause of GUI (58) followed by straddle injuries (18) and iatrogenic causes (12) and miscellaneous (12). The male- female ratio was 6:1. The urethral was also the most commonly injured organ (60.6); followed by the kidney (11.5). The testes were the least injured organs (1.6). The blunt renal injuries and extraperitoneal bladder injuries were managed by non operative means while most other injuries were managed by surgical intervention. Immediate treatment outcome was satisfactory in most patients. There was one mortality. CONCLUSION: Most cases of GUI are preventable. Improved safety on the roads;'proper training of surgeons and attention to clinical and surgical details will go a long way in preventing GUI. Early intervention significantly reduces the morbidity and mortality.

Background: Violent trauma especially by gunshot injuries appears to be on the increase worldwide. There is inadequate data from many centres in Nigeria to support this observation. Aim: To determine the pattern of gunshot injuries in the University of Port Harcourt Teaching Hospital (UPTH). Methods: This was a prospective study covering a period of three years (January 2002-December 2004). A standard proforma was used to record all cases of gunshot injuries reporting to the UPTH. Details sought were age, gender, occupation, gun type, anatomic region of the body involved and treatment given. Other information recorded were time of injury, duration of hospital stay, injury time before presentation, assailant and outcome. Information was obtained directly from victims, relations, the police or those accompanying the victim. Where surgical operations were done or patients were admitted to the wards, relevant information or findings were then retrieved from theatre and ward records. Results: There were 135 patients (120 males and 15 females) between the ages of 1½ -67 years. Students and civil servants constituted the largest number. Seventy-one injuries were due to high velocity missiles while 64 were low velocity. Armed robbery and attacks by “unknown assailants” were the commonest modes of attack with 47 and 41 victims respectively. The lower limbs, abdomen and chest were the most frequent anatomic regions involved recording 38, 28 and 27 cases respectively. There were 9 cases in which multiple anatomic sites were affected. The majority of patients (56) presented within 12-18 hours after injury; only 9 cases presented within 6 hours. Twenty-nine patients underwent laparotomy while 14 had thoracostomies. Forty-nine patients were treated and discharged. Minor surgery (like wound debridement) was the commonest treatment in 43 patients. All cases of fracture among these were subsequently referred to the trauma unit for appropriate treatment. Thirty patients died giving a mortality rate of 22.2%. Conclusion: Gunshot injuries constitute a major cause of violent trauma in the Niger Delta Region of Nigeria with a high and disturbing level of morbidity and mortality

Background: Violent trauma especially by gunshot injuries appears to be on the increase worldwide. There is inadequate data from many centres in Nigeria to support this observation. Aim: To determine the pattern of gunshot injuries in the University of Port Harcourt Teaching Hospital (UPTH). Methods: This was a prospective study covering a period of three years (January 2002-December 2004). A standard proforma was used to record all cases of gunshot injuries reporting to the UPTH. Details sought were age, gender, occupation, gun type, anatomic region of the body involved and treatment given. Other information recorded were time of injury, duration of hospital stay, injury time before presentation, assailant and outcome. Information was obtained directly from victims, relations, the police or those accompanying the victim. Where surgical operations were done or patients were admitted to the wards, relevant information or findings were then retrieved from theatre and ward records. Results: There were 135 patients (120 males and 15 females) between the ages of 1½ -67 years. Students and civil servants constituted the largest number. Seventy-one injuries were due to high velocity missiles while 64 were low velocity. Armed robbery and attacks by “unknown assailants” were the commonest modes of attack with 47 and 41 victims respectively. The lower limbs, abdomen and chest were the most frequent anatomic regions involved recording 38, 28 and 27 cases respectively. There were 9 cases in which multiple anatomic sites were affected. The majority of patients (56) presented within 12-18 hours after injury; only 9 cases presented within 6 hours. Twenty-nine patients underwent laparotomy while 14 had thoracostomies. Forty-nine patients were treated and discharged. Minor surgery (like wound debridement) was the commonest treatment in 43 patients. All cases of fracture among these were subsequently referred to the trauma unit for appropriate treatment. Thirty patients died giving a mortality rate of 22.2%. Conclusion: Gunshot injuries constitute a major cause of violent trauma in the Niger Delta Region of Nigeria with a high and disturbing level of morbidity and mortality

Background: The true incidence of vascular injuries in Ghana is not known on account of low reporting. Objective: We performed a study aimed at reviewing the pattern of injuries to peripheral vessels; and also the pattern of referral; presentation and management of these injuries at the Korle-Bu Teaching Hospital; Accra. Method: The study covered the period of January 1989 to March 2005 and involved a review of all peripheral vessel injuries referred for vascular surgical opinion. Results: Fifty two (52) patients with aged between 13- 50 years were reviewed. Penetrating trauma (82.7) and blunt trauma (11.5) were the commonest modes of injury. Arterial injuries (63.5) and combined arterial and venous injuries (23.1) were the commonest forms of injury. Brachial artery injuries were the commonest injuries seen. Associated nerve injuries occurred in 25 of patients most of whom also had brachial artery injuries. Late presentations of false aneurysms and arteriovenous fistulae were seen in 40.4patients. There were delays in referring patients (range 1 hour to 4 years). Vascular investigations like angiograms and duplex scanning were obtained in only 25.0 of patients. Vascular reconstruction was successful in 84.6patients and 7.7of patients required major limb amputation and an equal number of patients died from other injuries. Conclusion: There is undue delay in referring patientswith vascular injuries for intervention due to the inability of the initial attending medical personnel to recognize these injuries. Most of these injuries can be adequately treated without the use of sophisticated investigations; which are usually expensive.

Background: The true incidence of vascular injuries in Ghana is not known on account of low reporting. Objective: We performed a study aimed at reviewing the pattern of injuries to peripheral vessels; and also the pattern of referral; presentation and management of these injuries at the Korle-Bu Teaching Hospital; Accra. Method: The study covered the period of January 1989 to March 2005 and involved a review of all peripheral vessel injuries referred for vascular surgical opinion. Results: Fifty two (52) patients with aged between 13- 50 years were reviewed. Penetrating trauma (82.7) and blunt trauma (11.5) were the commonest modes of injury. Arterial injuries (63.5) and combined arterial and venous injuries (23.1) were the commonest forms of injury. Brachial artery injuries were the commonest injuries seen. Associated nerve injuries occurred in 25 of patients most of whom also had brachial artery injuries. Late presentations of false aneurysms and arteriovenous fistulae were seen in 40.4patients. There were delays in referring patients (range 1 hour to 4 years). Vascular investigations like angiograms and duplex scanning were obtained in only 25.0 of patients. Vascular reconstruction was successful in 84.6patients and 7.7of patients required major limb amputation and an equal number of patients died from other injuries. Conclusion: There is undue delay in referring patientswith vascular injuries for intervention due to the inability of the initial attending medical personnel to recognize these injuries. Most of these injuries can be adequately treated without the use of sophisticated investigations; which are usually expensive.